Bone grafting is a form of reconstructive surgery that helps to generate and rebuild bone and increase bone density to allow for proper support of dental implants or prostheses. In addition to dental implants, bone grafting may be required to address defects in a patient’s jaw.
When a tooth is lost, the surrounding bone often is often affected over time. Patients without enough jaw bone mass are not candidates for dental implants. Bone grafting is often performed to reverse bone loss or enhance existing bone, allowing for the placement of dental implants after the bone graft has healed and created the necessary foundation for the implants.
Bone grafting surgery may also be performed to correct problems resulting from:
- Defects present from birth
- Removal of a tumor
- Tooth loss and subsequent loss of bone in the related jaw area
Bone grafting for the purpose of rebuilding jaw bone to support dental implants can usually be done in our office. For more extensive bone grafting procedures, such as the correction of congenital defects, a hospital setting is required and grafting material may be taken from other areas such as the skull or hip.
The surgeon may recommend that the grafting material be taken from the patient’s own bone or from another source. Synthetic material can also be used to generate bone growth. Healing time prior to the placement of the implants is generally between 4 – 6 months, though it can sometimes take longer.
Types of Bone Grafts
Also known as autografts, these grafts are harvested directly from the patient, typically from the jaw, chin, lower leg bone or hip. These live grafts will work with the surrounding bone to create new bone in the treated area.
Also known as allografts, these grafts are harvested from cadaver bone. This type of graft can not create new bone on its own, so it is used to create a framework around which the surrounding bone will grow and fill.
These bone grafts are harvested from cadaver bone of another species, typically a cow. Before being placed, these grafts are treated at very high temperatures to help prevent rejection and possible contamination. Since these grafts are non-living like allogenic grafts, they serve as a framework for the growth of the surrounding bone.
Bone Graft Substitutes
Bone Morphogenetic Proteins (BMP)
Bone Morphogenetic Proteins (BMP) is a growth factor that is used to stimulate bone growth. It can be used to combat jaw bone resorption or supplement bone to accommodate an implant.
Demineralized Bone Matrix (DBM)
DBM is created by extracting proteins, collagen and growth factors from processed allograft bone and comes in several forms: putty, powder or a gel.
This type of substitute can be created by combining bone grafting materials with growth factors to encourage bone growth. Examples of graft composites include DBM combined with the cells from the patient’s bone marrow, a combination of collagen and ceramic composite or a composite created using collagen, ceramic and an autograft.
Bone Grafting Procedures
Guided Bone Regeneration
This procedure is used to regenerate lost bone around existing teeth, or in an area where teeth have been extracted. This procedure is often performed to protect your existing teeth and the tissues that keep them in place from bacterial plaque. The gingival tissue is folded back to remove the disease-causing bacteria. Membranes, bone grafts or tissue-stimulating proteins can be used to encourage the body’s natural ability to regenerate bone and tissue.
Ridge Augmentation involves placing a regenerative bone grafting material into empty tooth sockets to rebuild bone where an extraction has left an empty, weakened area. This process encourages the patient’s natural capacity to heal and regenerate bone.
Sinus augmentation adds bone to the upper jaw in the premolar and molar areas of the mouth. To add bone, an incision is made where the premolar and molar teeth were previously located. Once the bone is exposed, a small circular shape is made in the bone to access the sinus. Once the sinus is accessed, the sinus membrane is gently pushed up and away from the upper jaw. Once this is done, bone graft material is placed into the sinus space to change the shape and provide support. Once the bone is in place, the incision is closed and the healing process begins.
Socket preservation is a procedure performed after an extraction to help prevent further bone loss. During this procedure, bone grafting materials or bone growth enhancing elements are placed into the socket created by the extracted tooth to prevent resorption of bone.